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Licensed Clinical Review Nurse

Company: VirtualVocations
Location: Abilene
Posted on: November 8, 2024

Job Description:

A company is looking for a Clinical Review Nurse - Prior Authorization to analyze prior authorization requests for medical necessity and appropriate levels of care.



Key Responsibilities

Perform medical necessity and clinical reviews of authorization requests
Coordinate with healthcare providers and interdepartmental teams for timely service reviews
Assist with service authorization requests for member transfers or discharge plans


Required Qualifications, Training, and Education

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2 - 4 years of related experience
Licensed Practical Nurse (LPN) State Licensure required
Clinical knowledge and ability to analyze authorization requests preferred
Knowledge of Medicare and Medicaid regulations preferred

Keywords: VirtualVocations, San Angelo , Licensed Clinical Review Nurse, Healthcare , Abilene, Texas

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